الفهرس 
Brain TumorsOnly 14 pages are availabe for public view
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Abstract
Brain tumors, a heterogenous group of diseases, that collectively are the second most frequent malignancy in childhood and adolescence. Mortality among this group approaches 45%. In addition, these patients have the highest morbidity, primarily neurologic, of all childhood malignancies. However, outcomes have improved over time, owing to identification of chemotherapy and radiotherapy as a therapeutic modalities.
Epidermal growth factor receptor (EGFR) is a transmembrane tyrosine kinase receptor that plays an important role in the regulation of cell growth, proliferation and differentiation.
Overexpression of EGFR has been detected in prostate, brain, head and neck, thyroid, ovarian, bladder, gliomas and renal carcinomas and has been correlated with an advanced tumor stage and a poor clinical prognosis.
The aim of this study was to assess serum epidermal growth factor receptor levels in children with brain tumors and to correlate its level to different clinicopathological features of the patients.
A case-control study included 25 patients with primary brain tumors, presented to the Neurosurgery Department, Ain Shams University and to the Pediatric Oncology Unit at Nasser Institute Hospital for research and treatment, during the period between March 2008 and November 2008. A group of 20 children were included as control group.
All studied patients were subjected to careful history taking, thorough clinical examination, neuroradiological evaluation, routine lab investigations, histopathological examination and s.EGFR level determination.
According to the available data, patients were evaluated for age, sex, clinical presentation histopatho-logical diagnosis and tumor site according to neuroimaging. All patients were studied preoperatively and before receiving any treatment.
The mean age of studied patients was 8.06 years with predominance of the female patients (52%).
Headache and vomiting were the most common presenting symptoms among the patients followed by motor weakness and then seizures.
Most of our patients had infratentorial tumors (64%) and only 44% of them had hydrocephalic changes at diagnosis.
Seven histopathological types of brain tumors were identified in our patients. The most common type was medulloblastoma followed by astrocytoma and brain stem glioma.
All tumors were graded according to the WHO grading system of brain tumors.
A statistically highly significant elevation of s.EGFR in patients with brain tumors when compared to the healthy controls.
Assessment of the sensitivity and specificity of s.EGFR level as a diagnostic test for brain tumors was done and showed that it has 96% sensitivity and 90% specificity with a cutoff value 50 fmol /ml.
The overall survival rate at 6 months for the patients was studied in relation to histopathology of the tumor showing no statistically significant difference. Also, no statistically significant difference in OSR at 6 months when compared to s.EGFR. Yet, a statistically highly significant difference was found in OSR at 6 months when compared to tumor grades.
There was no statistically significant difference in s.EGFR in relation to their age, sex, presenting symptoms, neurologic sequelae, anatomical site of the tumor or its grade.